A case of supraventricular tachycardia misdiagnosis after dual-chamber implantable cardioverter defibrillator implantation with His bundle pacing

The combined use of an implantable cardioverter defibrillator (ICD) and His bundle pacing (HBP) is believed to benefit patients with dilated cardiomyopathy (DCM) and atrial fibrillation but needs more guidance built on clinical experience. A patient who had an implanted dual-chamber ICD with HBP presented to our hospital with DCM and atrial fibrillation. In the present case, the criteria for differential diagnosis were set as "if all," which requires matching the morphological template, sudden onset, and interval stability. Ventricular tachycardia (VT) was misdiagnosed as supraventricular tachycardia due to morphological matching to sinus tachycardia. The misdiagnosis and mistaken VT treatment(ICD adaptive treatment) highlight the importance of personalized settings for differential diagnosis to avoid such a misdiagnosis or omission.